Merriam-Webster's definition states: "The practice of ordering medical tests, procedures or consultations of doubtful clinical value in order to protect the prescribing physician from malpractice suits."

According to surveys by Jackson Healthcare and Gallup, physicians estimate that defensive medicine practices cost the U.S. between $650 - $850 billion annually.

Defensive medicine is a significant force driving the high cost of healthcare in the U.S. Not only are the vast majority of physicians practicing defensive medicine, more and more younger physicians are taught to do so in order to protect their livelihood and reputation against the threat of lawsuits.

Physicians estimate the cost of defensive medicine to be between 26 and 34 percent of annual healthcare costs in the U.S. However, the adverse impact is not limited to costs. Limited access to care for certain patients, over- and under-treatment of life-threatening illnesses, delayed adoption of medical innovations, and physician dissatisfaction are among the most significant impacts.

Today's physicians believe that patients are adversely impacted as a result of these practices. Patients most likely affected by defensive medicine are those requiring surgery and those visiting emergency rooms. Our research also revealed that women are more affected by defensive medicine than men.

Emergency room, primary care, and OB/GYN physicians are the most likely to practice defensive medicine. Surgeons and OB/GYNs are most affected by the threat of lawsuits with 79 percent and 83 percent having been named in lawsuits respectively. Younger physicians and female physicians reported less tolerance for risk and are more likely to practice defensive medicine.

As America embarks on "reforming" healthcare, it is imperative to examine the role that defensive medicine plays in the cost and quality of healthcare across the nation. This book highlights the key findings of our recent research, and includes written responses from physicians that give voice to this overlooked trend.